=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831191071
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARTHA RUTH MORSE MD, FAAP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/01/2005
-----------------------------------------------------
Last Update Date | 02/09/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 333 N SANTA ROSA ST
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78207-3108
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-704-4708
-----------------------------------------------------
Fax | 210-704-4722
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 315 N SAN SABA
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78207-3154
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-704-3049
-----------------------------------------------------
Fax | 210-704-4527
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | G6858
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2080P0214X
-----------------------------------------------------
Taxonomy Name | Pediatric Pulmonology Physician
-----------------------------------------------------
License Number | G6858
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------